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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KALLI R GLASS DO
NPI 1124715321
Family Medicine in Gonzales, TX

Active since April 19, 2023PECOS EnrolledAccepts Medicare Assignment
1110 N SARAH DEWITT DR, GONZALES, TX 78629(830) 672-8502(830) 541-5557 Get Directions Write a Review

NPPES record last updated: September 25, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 25, 2026, May 11, 2026 (2 updates tracked since 2026).

About Kalli R Glass Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KALLI R GLASS DO (NPI 1124715321) is an individual family medicine provider in Gonzales, Texas, licensed in Texas (W5348) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and is a graduate of Other (2026).

NPPES Registry Identity

NPI1124715321
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKALLI R GLASSCredential: DO
Location Address1110 N SARAH DEWITT DRGonzales, TX 78629-3311
Mailing Address1110 N Sarah Dewitt DrGonzales, TX 78629-3311 · (830) 672-8502 · Fax (830) 541-5557
Phone(830) 672-8502
Fax(830) 541-5557
Sole ProprietorNo
Medical School CMSOtherGraduated 2026
Enumeration DateApril 19, 2023
Last NPPES UpdateSeptember 25, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 25, 2026
✔ NPI 1124715321 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · W5348
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1110 N SARAH DEWITT DR, Gonzales, TX 78629
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Other Names 1

Former Name (1)Kalli Davis

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kalli R Glass Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991151953
PECOS Enrollment IDI20260522003389
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kalli Glass reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gonzales Healthcare Systems
Same address
Rural Health
1110 N SARAH DEWITT DR
Gonzales, TX 78629
  • Reassigned Medicare billing, Texas enrollment
  • 58 clinicians in this Medicare group
NPI 1013916287 (830) 672-7581

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital

Acute Care Hospitals · Gonzales, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450235
Location1110 North Sarah Dewitt DriveGonzales, TX 78629 · Gonzales County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78629 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GONZALES HEALTHCARE SYSTEMS
Clinic/Center (Rural Health)
1110 N SARAH DEWITT DR
GONZALES, TX 78629
Gonzales County (830) 672-7581
DR. KATHLEEN MARY KOERNER D.O.
Surgery
1110 N SARAH DEWITT DR
GONZALES, TX 78629
Gonzales County (830) 672-8502
GONZALES HEALTHCARE SYSTEMS
Medicare Defined Swing Bed Unit
1110 N SARAH DEWITT DR
GONZALES, TX 78629
Gonzales County (830) 672-7581
DR. WILLIAM E CRAIG MD
Internal Medicine (Cardiovascular Disease)
1110 N SARAH DEWITT DR
GONZALES, TX 78629
Gonzales County (830) 672-3845
MR. TODD MICHAEL CRAWFORD PHYSICIAN ASST - C
Physician Assistant
1110 N SARAH DEWITT DR
GONZALES, TX 78629
Gonzales County (830) 672-8502
VICTORIA EMERGENCY PARTNERS LLC
Emergency Medicine
1110 N SARAH DEWITT DR
GONZALES, TX 78629
Gonzales County (830) 672-7581
DR. SEAN HATTENBACH M.D.
Family Medicine
1110 N SARAH DEWITT DR
GONZALES, TX 78629
Gonzales County (830) 672-8502
KAREN FORTUNE
Speech-Language Pathologist
1110 N SARAH DEWITT DR
GONZALES, TX 78629
Gonzales County (830) 672-7581

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kalli Glass's NPI number?

The NPI number for Kalli Glass is 1124715321. It was assigned to this individual provider in the NPPES registry on April 19, 2023. The provider is also known as Kalli Davis.

Where is Kalli Glass located?

Kalli Glass practices at 1110 N Sarah Dewitt Dr, Gonzales, TX 78629. The listed phone number is (830) 672-8502.

What is Kalli Glass's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kalli Glass enrolled in Medicare?

Yes. Kalli Glass is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kalli Glass's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kalli Glass reassigns Medicare benefits to Gonzales Healthcare Systems (Gonzales, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kalli Glass's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Kalli Glass affiliated with any hospitals?

According to CMS data, Kalli Glass is affiliated with Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Kalli Glass was last updated on September 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.